Quantum Sufficit

Just Enough

JESSICA GREENE

Am Fam Physician. 2000 Jan 1;61(1):29-30.

Holidays and heart attacks go hand in hand, according to a report in Circulation. The months of December and January score highest in recorded heart-attack deaths. The rise in heart trouble is attributed to holiday bingeing on fatty foods and alcohol and the increased use of wood-burning fireplaces as smoke particles can put stress on the heart and lungs, reports Time.

Treatment of depression during pregnancy can be tricky business. According to National DMDA, the newsletter of the National Depressive and Manic-Depressive Association, more than 60 percent of women take some type of medication during pregnancy. Although the use of antidepressant medications during pregnancy and lactation is generally discouraged, new findings indicate that drastic measures to cease treatment may do more harm than good. Abruptly stopping the medication increases the risk of relapse of depression and serves little purpose, because most pregnancies are not confirmed until at least five to seven weeks in gestation and most organ systems are already developed by the eighth week. Studies performed at Harvard and UCLA found that breast-feeding risks involving antidepressants are relatively low, because an infant receives less than 1/500th of the maternal dose.

Do you routinely ask your patients about all possible drug use? You should, suggests results of a recent study released by the Substance Abuse and Mental Health Services Administration, reported in Psychiatric News. The survey, which tracked trends in treatment admissions from 1992 to 1997, found that the number of admissions for heroin addiction treatment has surpassed that for cocaine addiction. Opiate use admissions climbed to 16 percent in 1997, while cocaine use admissions fell to 15 percent from the 18 percent recorded in 1992. Admissions for alcohol abuse were highest, accounting for 27 percent of admissions, and marijuana use increased from 6 to 13 percent. Injected heroin accounted for 68 percent of all heroin-related admissions in 1997, down from 77 percent in 1992, while inhaled heroin jumped from 19 to 28 percent. Experts admonish physicians to watch for signs of drug use in adolescents and younger adults, including middle-class and wealthier patients.

Breast-fed babies are less likely to grow into obese children, suggests a report in U.S. News & World Report. A recent study of 9,000 kindergartners showed that children who had been exclusively breast-fed for three to five months were 35 percent less likely to become obese than other children.

Plastic surgeons often “leech” into action when poor circulation compromises the survival of reconstructed skin flaps. According to the Journal of the National Cancer Institute, problems with re-establishing blood flow in plastic surgery occur in about 10 percent of cases. Once traditional methods fail, such as pricking the skin with needles or using drugs to dilate blood vessels, plastic surgeons often enlist the help of the 1- to 2-inch long leeches. The bite of the leech does not hurt because of an anesthetic compound present in its saliva. By consuming up to five times its body weight in blood and injecting an anticoagulant into the wound, leeches help restore normal blood flow to the compromised region. The medicinal Hirudo medicinalis leeches cost approximately $7 each and also can be used to dissolve blood clots and inhibit platelet aggregation.

A college course in asthma might not be a bad idea, suggests the Allergy and Asthma Network. Molds, dust mites, viruses and bacteria are just a few of the problems that patients with asthma may encounter at college. With careful planning and wise choices, life-threatening situations can be avoided. The Allergy and Asthma Network/Mothers of Asthmatics, Inc. developed a small list of suggestions to help students with asthma who are heading to college. The list included the following tips: students should be reminded to keep their rooms as clean as possible, avoid second-hand furniture and rugs, avoid exposure to cigarette smoke, insist on the top bed of bunk beds, wash sheets and blankets regularly, store medications in moisture-proof containers, wash their hands frequently, use a room air filter and develop an emergency plan for use in case of serious asthma attacks.

The total number of medical school applicants in 1998–99 was down 4.7 percent from the 43,020 applicants who entered in 1997, reports Physician's Financial News. The decrease, which is predicted to continue, may be caused by concerns about managed care and the estimated $100,000 debt incurred by students on graduation.

Been busy lately? You're not alone. According to Internal Medicine News, family physicians receive the greatest number of office visits of any group of specialists. The information provided by the U.S. Bureau of Census and the National Center for Health Statistics shows that family physicians received over 200 million visits in 1997, followed by internists with 121 million visits. Pediatricians checked in with 91 million visits, while psychiatrists had 25 million.

Bad penmanship may have serious consequences, reports the National Law Journal. According to a recent report, a physician in Texas has been punished for his sloppy scribbling after a pharmacist misread one of his prescriptions. The error lead to the overdose and subsequent death of a cardiology patient. The family of the patient was rewarded $450,000 by a jury who found the physician and the pharmacist each 50 percent liable. The prescription called for Isordil and was misread as Plendil because of the careless writing.

When it comes to smoking, we're all ears. A recent study shows that adults who lost their hearing before the age of three years are 50 percent less likely to smoke than hearing adults. According to the report, published in Health Education Reports, those who encounter deafness earlier in life have less exposure to tobacco advertising. However, adults who become deaf later in life smoke at the same rate as hearing adults.

Men living in the United States are two to three times more likely than women to develop cancers of the lip, tongue, mouth or throat, reports the Journal of the National Cancer Institute. Studies first published in SEER Cancer Statistics Review and Cancer Rates and Risks show that cancers of the floor of the mouth and gums are more common in white men, while throat cancer is more prevalent in black men. In 1995, the incidence of cancer of the lip, tongue, mouth or throat was 15 cases per 100,000 white men and 20 cases per 100,000 black men. The major risk factors associated with these cancers are tobacco and alcohol use.